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Research Paper
Open Access

Childhood trauma and cognitive deficits in patients with schizophrenia: mediation by orbitofrontal cortex H-shaped sulci volume

Leilei Wang, Yi Yin, Wei Feng, Yanfang Zhou, Junchao Huang, Ping Zhang, Song Chen, Hongzhen Fan, Yimin Cui, Xingguang Luo, Shuping Tan, Zhiren Wang, Baopeng Tian, Li Tian, Chiang-Shan R. Li and Yunlong Tan
J Psychiatry Neurosci June 07, 2022 47 (3) E209-E217; DOI: https://doi.org/10.1503/jpn.210178
Leilei Wang
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Yi Yin
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Wei Feng
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Yanfang Zhou
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Junchao Huang
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Ping Zhang
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Song Chen
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Hongzhen Fan
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Yimin Cui
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Xingguang Luo
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Shuping Tan
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Zhiren Wang
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Baopeng Tian
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Li Tian
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Chiang-Shan R. Li
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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Yunlong Tan
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
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    Figure 1

    Correlation between childhood trauma and left OFC H-shaped sulci volume in patients with first-episode schizophrenia and healthy controls: (A) emotional neglect subscore; B) physical neglect subscore; (C) CTQ total score. Associations were significant at p < 0.05 after adjusting for age, sex, education level and total intracranial volume for PFES. CTQ = Childhood Trauma Questionnaire; HC = healthy controls; OFC = orbitofrontal cortex; PFES = patients with first-episode schizophrenia.

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    Figure 2

    Model 1, path diagram of the mediation model (x = emotional neglect; y = MCCB total score; left OFC H-shaped sulci volume as mediator). Paths C’ and C represent the direct and total effects between emotional neglect and left OFC H-shaped sulci volume. Path AB represents the mediation effect and was significant at p < 0.05. CI = confidence interval; MCCB = MATRICS Consensus Cognitive Battery; OFC = orbitofrontal cortex.

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    Figure 3

    Model 2, path diagram of the mediation model (x = CTQ total score; y = MCCB total score; left OFC H-shaped sulci volume as mediator). Paths C’ and C represent the direct and total effects between CTQ total score and left OFC H-shaped sulci volume. Path AB represents the mediation effect and is significant at p < 0.05. CI = confidence interval; CTQ = Childhood Trauma Questionnaire; MCCB = MATRICS Consensus Cognitive Battery; OFC = orbitofrontal cortex.

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    Table 1

    Participant characteristics

    CharacteristicaPatients with first-episode schizophrenia
    n = 63
    Healthy controls
    n = 48
    Statisticp value
    Male/female30/3328/20χ2 = 1.250.26
    Age, yr27.5 ± 6.830.5 ± 7.8t = −2.180.31
    Education, yr13.2 ± 3.313.8 ± 2.6t = −0.960.34
    Age at onset, yr26.8 ± 7.5NANANA
    Illness duration, mo11.6 ± 12.2NANANA
    CTQ
     Emotional abuse subscore7.09 ± 2.316.00 ± 1.46z = −2.890.004
     Physical abuse subscore5.68 ± 1.585.40 ± 1.25z = −1.530.13
     Sexual abuse subscore6.05 ± 2.835.17 ± 0.37z = −2.310.020
     Emotional neglect subscore9.32 ± 4.027.67 ± 2.94z = −2.170.030
     Physical neglect subscore11.14 ± 2.2310.10 ± 1.36z = −2.420.016
     Total score39.29 ± 7.9134.33 ± 5.12z = −3.76< 0.001
    MCCB
     Speed of processing subscore49.65 ± 11.1556.72 ± 7.55F = 44.81< 0.001
     Attention or vigilance subscore42.33 ± 8.7257.98 ± 7.01F = 87.14< 0.001
     Working memory subscore48.35 ± 9.8058.89 ± 5.45F = 36.170.002
     Verbal learning subscore49.65 ± 11.1556.73 ± 7.55F = 10.18 <0.001
     Visual learning subscore47.35 ± 9.5655.82 ± 6.04F = 10.18 <0.001
     Reason and problem-solving subscore49.10 ± 9.0257.05 ± 6.16F = 32.34< 0.001
     Social cognition subscore46.56 ± 8.5054.20 ± 10.26F = 12.580.001
     Composite score46.00 ± 8.3258.89 ± 5.80F = 78.95< 0.001
    Right OFC H-shaped sulci volume, cm32.49 ± 0.262.52 ± 0.37F = 0.060.81
    Left OFC H-shaped sulci volume, cm32.56 ± 0.312.69 ± 0.36F = 6.250.014
    • CTQ = Childhood Trauma Questionnaire; MCCB = MATRICS Consensus Cognitive Battery; NA = not applicable; OFC = orbitofrontal cortex.

    • ↵* Adjusting for sex, age, education level and total intracranial volume as covariates in the general linear model. Values are mean ± standard deviation unless otherwise indicated.

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Journal of Psychiatry and Neuroscience: 47 (3)
J Psychiatry Neurosci
Vol. 47, Issue 3
22 Jun 2022
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Childhood trauma and cognitive deficits in patients with schizophrenia: mediation by orbitofrontal cortex H-shaped sulci volume
Leilei Wang, Yi Yin, Wei Feng, Yanfang Zhou, Junchao Huang, Ping Zhang, Song Chen, Hongzhen Fan, Yimin Cui, Xingguang Luo, Shuping Tan, Zhiren Wang, Baopeng Tian, Li Tian, Chiang-Shan R. Li, Yunlong Tan
J Psychiatry Neurosci Jun 2022, 47 (3) E209-E217; DOI: 10.1503/jpn.210178

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Childhood trauma and cognitive deficits in patients with schizophrenia: mediation by orbitofrontal cortex H-shaped sulci volume
Leilei Wang, Yi Yin, Wei Feng, Yanfang Zhou, Junchao Huang, Ping Zhang, Song Chen, Hongzhen Fan, Yimin Cui, Xingguang Luo, Shuping Tan, Zhiren Wang, Baopeng Tian, Li Tian, Chiang-Shan R. Li, Yunlong Tan
J Psychiatry Neurosci Jun 2022, 47 (3) E209-E217; DOI: 10.1503/jpn.210178
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